MTX 15-20 mg/m2 given orally once a week was found to be an effective treatment for both extended oligoarticular and systemic JIA in this shortterm trial. Long-term efficacy needs to be addressed in future studies.

The association between the clinician's assessment, core outcome variables and MRI findings in this study was limited. This indicates that clinical and laboratory findings are inadequate diagnostic tools for the assessment of hip arthritis when compared with MRI as the gold standard.

MRI in ICH clearly demonstrates cartilage loss and enables delineation of bone and muscle abnormalities. It is helpful in the differential diagnosis of hip joint disease in children and may provide further information on the progression and aetiology of ICH.

Recent high‐profile cases have made paediatricians very aware of the serious implications of either missing or wrongly diagnosing non‐accidental injury. Subdural fluid collections in non‐mobile infants usually represent haemorrhage caused by non‐accidental injury. We report a 6‐month‐old male who presented to the Accident and Emergency Department of Birmingham Heartlands Hospital with bilateral subdural fluid collections and skin ulcers resembling cigarette burns. Non‐accidental injury was considered to be the most likely diagnosis. However, while under observation in hospital, the child’s neurological condition deteriorated with progressive cerebral infarctions, and serial photographs of the skin lesions showed failure to heal. The revised diagnosis, confirmed histologically, was Degos disease, an extremely rare and often fatal occlusive vasculopathy. The child was treated palliatively and died 8 weeks after presentation. This report informs doctors of a new simulator of non‐accidental injury to be considered in infants with otherwise unexplained subdural fluid collections.

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